Bahamas: Missing Female Diver

[AlaskaDiver]

I have become engrossed in reading this thread since the beginning and am awaiting more factual details. Sadly the detailed analysis I seek may not ever be provided. Given that fact, I'd like to think that I can take away some piece of this thread that I can use to prevent accidents in my own diving and during dives where I am the designated DM. I am a volunteer DM at our local dive shop and love to point out the creatures underwater and talk about gear topside. It is really a rewarding experience and all fun dives I have been leading have ended safely. I want this to continue.

With that said, there have been occasions where one diver simply surfaces due to their own issues (sinus pressure, ear clearing problems, improper weighting, buoyancy issues and more). Until I personally see the person diving or have a better understanding of their skills, I will not take them to an area where the dive is a beyond their known skill levels. These are all divers with dramatically varying levels of newness to diving. Unless I saw an individual in a problem situation, I don't hold hands or tanks. I'm a guide on the dives.

I read what Amazz had to say and wanted to say 'Thanks' many times over to Angie. Her account of a couple in FL who continually refused assistance and were ignorant of their imminent danger is more common than one might want to think.

I was on a live boat-drop in Palau at the Pelilieu Express after being briefed that there was a 2 knot down-welling current and to stay near 40 to await the DM's hand instructions in order to move toward the reef, hook in and watch the large pelagics swim along the edge. As we approached the reef, an unexpected surge in the down-welling current followed by an even stronger up-welling current, ripped us directly toward the reef at 5 knots. Divers were scattered frantically looking for anything to slow them down. All began hitting the smooth reef. I hit my hip hard and endured a large painful bruise. Most had bloodied hands, legs or arms. We all surfaced individually. Some of the people did not have signaling devices even after the captain reminded us several times prior to entering the water. I had to wait in the water until all the other divers without sausages were retrieved before I was picked up despite following protocol. Captain said that was enough and that we were headed back to the dock. Several of these same divers were attempting to bully the captain into another dive site complaining about how much money they paid. Most missed seeing the inherent danger of the situation into which they were putting themselves.

My point here is that no matter how many briefings a DM does, no matter how many reminders of the seemingly simple, common sense preventative measures to be taken while diving advanced sites; people still will want to point the finger at someone else for their own ineptitude, omissions or errors. I know in this thread's various postings some have said that they could have changed the situation with their rescue skills and techniques. I can't definitively say those things as I was not on the dive in question and I've never had to drag a resisting diver from depth. I'm wondering why a more rapid responsive action by the DM to the female diver descending wasn't made. Others in this thread have expressed understanding of the DM's inability to retrieve the victim. I'm somewhere in the middle until I can see more of the facts since these are all speculative scenarios based on a combination of our own experiences, what has been taught in dive courses and the sparse factual data provided. I'm not surprised to read people blaming the DM on various levels, but I refuse to kill myself attempting to save the life of someone who would repeatedly and blatantly disregard my attempts to get them out of a dangerous situation.

 

[Thalassamania]

I really do think that we are way too focused on the end stage of the accident and not focused enough on the series of failures that lead up to that final failure.

 

[caseybird]

There is one great big failure evident here: The deceased decided to dive one month after a stroke. Does anyone here believe a doctor cleared her for scuba one month later? No DM can control a situation where the diver refuses to be responsible for the most basic protocol. Medical fitness to dive is not optional. If she truly wanted to get into the water, snorkeling would have be appropriate.

 

[bowlofpetunias]

There is one great big failure evident here: The deceased decided to dive one month after a stroke. Does anyone here believe a doctor cleared her for scuba one month later? No DM can control a situation where the diver refuses to be responsible for the most basic protocol. Medical fitness to dive is not optional. If she truly wanted to get into the water, snorkeling would have be appropriate.

I absolutely agree! The odds were stacked against this diver and DM before they got in the water!

My sympathy to Mrs Woods family but before we chose to get into the water we need to assess the risks. Sometimes we are lucky enough to have a warning that a health problem increases our risks. As adults it is our responsibility to assess those risks in a reasonable manner and make our informed choices. If the Doctor did not make it clear how inappropriate diving was at this time I would suggest that either the Doctor did not know they were planning to dive or IMHO failed to educate them adequately.

TIA and RIA's are major warning of a full blown stroke. I would be interested to know if Mrs Wood displayed any residual effects from her previous "stroke". Did anyone note less mobility on one side, weakness, or any (perhaps) slight slurring of speech?

Strokes are a form of brain injury. Symptoms of brain injury often effect risk recognition skills and result in combative behavior, inability to relate to the impact of one's behavior on others (often misunderstood as selfishness). They may act like a petulant child which seems consistent with Mrs Wood's (reported) response to the DM in the water. Stroke victims and their families need to be educated about these things. Mrs Wood may or may not have been capeable of absorbing this education..... That fact puts a lot of pressure on her family. It is hard to know when to step in and make decisions for a loved one.

This forum is supposed to be an effort to learn in a way that reduces the chance of future incidents. I would suggest that a big lesson here is for people especially Dive Operators, Instructors and DM's to be alert for the often subtle signs of "stroke". Cardiovascular disease has always been a significant problem but it is getting worse with our aging population. Often it is people who are in the higher risk category who can now afford the time and money to go on dive vacations.

Here in OZ there has been a great push for awareness using the term FAST....

Facial droop (may just look less wrinkled on one side)
Arm weakness (possibly unable to lift it above their shoulder)
Speech difficulty (often slurred or confused)
Time is of the essence a bigger one may occur at any time.. medical intervention is critical

Once again my deepest sympathy to the Woods family and DM in particular but also to those others impacted by this incident.

 

[Riger]

This forum is supposed to be an effort to learn in a way that reduces the chance of future incidents. I would suggest that a big lesson here is for people especially Dive Operators, Instructors and DM's to be alert for the often subtle signs of "stroke".

I understand your sentiments but wonder where one draws the line? How much should dive pro's know about medical conditions that have an impact on diving and then, even if they did identify what may be a symptom of something, should that be the grounds to disallow [-]them[/-] clients to dive or should they refer [-]them[/-] the client(s) to the dive doctor? I don't mean to to take an opposing stance, I understand where you are coming from.

Slight Detour Follows

In aviation, there is sad truth as follows;

When considering the retrofit of a fleet of aircraft to increase the (human) rate of survivability of certain types of accidents, often times a cost benefit analysis makes it cheaper to accept the risk of an accident every [insert expected period] years and pay out the insurance claims, than to make the recommended changes. This is a very cold (and impersonal) method of deciding whether or not to spend the money on such a change and is often done away from the public eye.

In some ways, I see a similarity in that dive operators could go the extra mile to improve the skills and training of their staff. They could employ more staff to exercise more vigilance over the processes they follow, provide training to enhance the staff awareness of the signs of medical conditions etc .... but at what cost? And even in the event of a serious accident, they still have to be proven to have been negligent (in a country where they can be legally pursued) before the impact becomes tangible to them.

I suppose the point I am trying to make is that there are many pro-active methods that can be applied to enhance safety and reduce risk but, the result would ultimately be increased cost to the end-users and the potential loss of business for the operators.

Make no mistake, I am all for improving safety, I just don't think the operators can afford it without a significant impact on the cost to deliver a service.

(Added after posting : Scuba diving is an activity of increased risk when compared to many other recreational activities. Increased risk means increased likelihood of accidents and incidents. Short of regulating the activity, there is a point beyond which the associated risks cannot be mitigated.)

Best Regards
Richard

 

[bowlofpetunias]

I know what you mean and you are talking about reality...costs, and the issues of people making their own choices... I agree on all of that but DM's and Rescue Dive courses are required to take first aid training..... the tropic of Stroke and issues specific to diving are not well covered in many of those courses because they are not specific dive first aid courses. I know.. I teach them.

The goal in this area is to talk about possible preventive measures. DAN provides this type of information.... I am suggesting that as part of ongoing maintaining of skills that people should be encouraged to seek the information and be on the lookout for indicators. We all agree that ongoing practice is important to keep skills adequate. I am suggesting that encouraging ongoing learning in this area is also important.

I honestly don't know how it should/could be handled. If I was on a boat and noticed these signs... I would most likely make a friendly contact with the person and try to nicely find out how more.. then if necessary make my suggestion to them that they reconsider diving. If this did not work... I would advise the boat operator of my concern. In the end I would know I did all I could if something went wrong. I don't see this as any different from a Rescue Diver or DM going to a person on a dive and intervening to protect them from risky/dangerous actions during the dive.

I think the Dive Op and DM and Diver all are ultimately involved in decisions about when. when and where people get in the water. I think it is better to make those decisions based on knowledge.

It is up to those involved how much effort they put into their jobs. When the ship hits the sand.... their decisions may help or hurt them... and others..

JMO

 

[bsee65]

I can understand why some people are calling out the victim and suggesting she may have had some stroke-related episode while on the dive. In spite of all that, it doesn't relieve the DM of the responsibility to make an effective rescue. Based upon the responses here, the typical DM on a typical day should have been able to bring Mrs. Wood to the surface. I don't know, I don't have that training. I do know that handling a 50-70 year old woman behaving like a "petulant child" would be a no-brainer on dry land.

I'm all for putting some blame on the diver if she failed to disclose her medical condition, especially if it turns out that it was a factor in the accident. It's definitely a lesson to be learned that being healthy enough to walk around, or even jog, doesn't make you healthy enough to dive. The diver is 100% responsible for putting herself in a dangerous position, but that doesn't make her 100% responsible for her death. Deciding to dive with a potentially dangerous medical condition may very well have been the first error leading toward Mrs. Wood's death, but it wasn't the only one or the last.

 

[Riger]

Here is a question; Should (could) dive operators mandate a (recent) medical clearance certificate for all divers over a certain age? If so what age would be considered non-discriminatory but reasonable with respect to elevated risk?

Best Regards
Richard

 

[Riger]

I can understand why some people are calling out the victim and suggesting she may have had some stroke-related episode while on the dive. In spite of all that, it doesn't relieve the DM of the responsibility to make an effective rescue. Based upon the responses here, the typical DM on a typical day should have been able to bring Mrs. Wood to the surface. I don't know, I don't have that training. I do know that handling a 50-70 year old woman behaving like a "petulant child" would be a no-brainer on dry land.

I'm all for putting some blame on the diver if she failed to disclose her medical condition, especially if it turns out that it was a factor in the accident. It's definitely a lesson to be learned that being healthy enough to walk around, or even jog, doesn't make you healthy enough to dive. The diver is 100% responsible for putting herself in a dangerous position, but that doesn't make her 100% responsible for her death. Deciding to dive with a potentially dangerous medical condition may very well have been the first error leading toward Mrs. Wood's death, but it wasn't the only one or the last.

We are in the fortunate position of not being tasked to apportion blame in this incident however; given that most accidents and/or incidents are the result of a chain of single events and in many cases, the removal of any single link in the chain changes the outcome dramatically, surely you must agree that this is pertinent place to discuss each of those (failed) links individually or collectively no matter the degree to which that link factored into the event as a whole.

Best Regards
Richard

 

[bowlofpetunias]

Well put! I was typing a multi quote response and my internet dropped out and I lost it. I had typed a similar comment. No single event or individual is totally responsible here.

I have refrained from comment on the actions of the DM because I am not a DM and don't feel personally qualified to comment/judge what the DM could/should have been able to do in this situation.

I am not trying to "call out" the victim or family or doctor. I am trying to encourage people to look at this from a different but relative angle.

Dive Ops already mandate medicals for courses. I don't see it any different mandating medicals for particularly risky or dangerous sites but not the average recreational diving sites. That would be costly, hard to enforce and prone to claims of discrimination.

What I am suggesting is that a bit of observation and knowledge on the part of Instructors, DM's and others is a necessity. They can't be expected to recognize and diagnose their clients but they already do some observation now.

Someone who is obviously stressed, nervous and not able to set up their own gear set alarm bells ringing already. I have seen Boat Operators change sites to less challenging ones when they saw these warning signs. What I am suggesting here would be a similar thing.